Clinical analysis of thoracic exploration of chest trauma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李扬 ^1,2 ,  杨异 ² , 吴伟铭 ² , 何伟伟 ²

1. ;
2. ;

Corresponding author：

杨异, Email: dryangyi@aliyun.com

Keywords：

胸外伤; 开胸探查; 肺挫伤; 连枷胸

DOI：

10.7507/1007-4848.201601032

Video：

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目的探讨胸外伤开胸探查的手术指征及救治策略。方法回顾性分析我院自 2006 年 1 月至 2014 年 12 月经开胸探查救治 51 例胸外伤患者的临床资料，其中男 43 例、女 8 例，年龄 24（17～75）岁。结果全组损伤严重度评分（ISS）平均 19.4 分。闭合性损伤 16 例，开放性损伤 35 例，治愈 45 例（88.24%），死亡 6 例（11.76%）。死亡原因为心脏破裂、失血性休克、感染性休克、多器官功能障碍综合征（MODS）、弥散性血管内凝血（DIC）。结论及时就医、快速诊断、准确把握手术指征、多科室联合诊治是救治胸外伤的关键。

Citation： 李扬, 杨异, 吴伟铭, 何伟伟. Clinical analysis of thoracic exploration of chest trauma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 735-737. doi: 10.7507/1007-4848.201601032 Copy

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8.	Watins TR, Nathens AB, Cooke CR, et al. Acute respiratory distress syndrome after trauma: development and validation of a predictive mode. Crit Care Med, 2012, 40(8): 2295-2303.
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10.	Ferretti C. A prospective trial of poly-L-lactic/polyglyclic acid copolymer plates and screws for internal fixation of mandibular fractures. Int J Oral Maxillfac Surg, 2008, 37(3): 242-248.
11.	Granetzny A, El-Aal MA, Emam E. Surgical verus conservative treatment of flail chest Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg, 2005, 4(6): 583-588.
12.	Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thorac Surg Clin, 2007, 17(1): 25-33.
13.	Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12(1): 11-15.
14.	Rocco G, Fazioli F, Martucci N, et al. Video-assisted thoracic surgery rib resection and reconstruction with titanium plate. Ann Thorac Surg, 2011, 92(2): 744-745.
15.	崔建国, 张文. 电视胸腔镜治疗外伤性血气胸 31 例. 临床肺科杂志, 2011, 16(4): 563.

1. 黄继江, 王保毅, 储伟, 等. 胸外伤行开胸手术 26 例临床分析. 医学理论与实践, 2004, 17(11): 1292.
2. 刘东平. 胸外伤急诊开胸探查的手术配合. 中国现代医学杂志, 2004, 14(18): 142.
3. 骆峰, 季惠, 林名圣. 开放性胸外伤临床处理中电视胸腔镜的应用. 南昌大学学报(医学版), 2013, 53(1): 30.
4. 张健. 胸外伤 230 例临床分析. 中华现代外科学杂志, 2007, 4(5): 130.
5. 母存富, 张熠, 张文林, 等. 外伤性心脏破裂 13 例救治体会. 中国胸心血管外科临床杂志, 2015, 4(22): 388-390.
6. Roberts J, Weigelt JA. A case study of a multiply injured patient. Surg Clin N(Am), 2012, 92(6): 1649-1660.
7. Berg RJ, Okoye O, Teixeira PG, et al. The double jeopardy of blunt thoracoabdominal trauma. Arch Surg, 2012, 147(6): 498-504.
8. Watins TR, Nathens AB, Cooke CR, et al. Acute respiratory distress syndrome after trauma: development and validation of a predictive mode. Crit Care Med, 2012, 40(8): 2295-2303.
9. Perl M, Gebhard F, Brucrner UB, et al. Pulmonary contusion causes impairment of macrophage and lymphocyte immune functions and increase mortality with a subsequent septic chanllenge. Cri Care Med, 2005, 33(6): 1351-1358.
10. Ferretti C. A prospective trial of poly-L-lactic/polyglyclic acid copolymer plates and screws for internal fixation of mandibular fractures. Int J Oral Maxillfac Surg, 2008, 37(3): 242-248.
11. Granetzny A, El-Aal MA, Emam E. Surgical verus conservative treatment of flail chest Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg, 2005, 4(6): 583-588.
12. Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thorac Surg Clin, 2007, 17(1): 25-33.
13. Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12(1): 11-15.
14. Rocco G, Fazioli F, Martucci N, et al. Video-assisted thoracic surgery rib resection and reconstruction with titanium plate. Ann Thorac Surg, 2011, 92(2): 744-745.
15. 崔建国, 张文. 电视胸腔镜治疗外伤性血气胸 31 例. 临床肺科杂志, 2011, 16(4): 563.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of thoracic exploration of chest trauma

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